The validity of classification for the clinical presentation of intracranial dural arteriovenous fistulas

摘要: A number of classification schemes for intracranial dural arteriovenous fistulas (AVFs) have been published that claim to predict which lesions will present in a benign or aggressive fashion based on radiological anatomy. We tested the validity two proposed first time large single-institution study. series 102 AVFs 98 patients assessed at single institution was analyzed. All were classified according grading scales: more descriptive schema Cognard, et al. (Cognard) and recently by Borden, (Borden). According Borden classification, 55 Type I, 18 II, 29 III. Using Cognard 40 15 IIA, eight IIB, 10 IIA+B, 13 III, 12 IV, four V. Intracranial hemorrhage (ICH) nonhemorrhagic neurological deficit considered an presenting clinical feature. total 16 (16%) presented with hemorrhage. Eleven these hemorrhages (69%) occurred either anterior cranial fossa tentorial lesions. When analyzed none (0%) I AVFs, (11%) 14 (48%) III (p < 0.0001). After exclusion visual nerve deficits clearly related cavernous sinus feature presentation one (2%) five (28%) nine (31%) combined, (ICH deficit) seen most commonly located tentorium (11 (79%) 14) (three (75%) four), but this simply reflected higher grade locations. Aggressive strongly correlated types: seven (39%) 23 similar correlation classification: (7%) three (38%) (40%) (83%) (100%) V No location is immune from harboring capable presentation. Location itself only raises index suspicion dangerous venous anatomy some AVFs. The configuration as both classifications predicts ICH deficit.